'Environmental cleaning for hospitals' might sound like a green, non-toxic cleaning method that uses natural products to disinfect surfaces in medical facilities, but it's actually a crucial cleaning protocol that can help prevent the spread of healthcare-acquired pathogens (HAP), particularly drug-resistant disease like methicillin-resistant Staphylococcus aureus (MRSA).

A 2009 study by researchers at the University of California at Irvine found that rigorous environmental cleaning for hospitals can reduce the transmission of these antibiotic-resistant organisms to patients exposed to rooms in which the prior occupant had been colonized or infected with the bacteria. MRSA is highly infectious and cannot by treated with methicillin, which is the antibiotic of choice for most other forms of Staphylococcus.

Bacteria infections

Although most hospitals have made strong efforts to control the spread of the disease, transmission of MRSA is still common and associated with severe health risks; infections can include bacteremia, pneumonia or soft tissue abscesses and are associated with high mortality rates.

bacteriaThe bacteria can infect patients in hospitals when they enter the body through a cut, sore, catheter or breathing tube. Patients with weak immune systems are particularly at risk. Another drug-resistant infection, vancomycin-resistant enterococci(VRE), is less common but can also be fatal.

In addition to careful personal hygiene by patients, visitors and especially medical staff, environmental cleaning for hospitals can significantly reduce a patient's chance of infection with healthcare-acquired pathogens. The environmental cleaning method that has been proven to reduce the spread of HAP consists of three important changes to cleaning policies at hospitals:

  • Environmental services staff at the hospital are educated on the importance of repeated bucket immersion while cleaning.
  • Rather than applying disinfectant directly to cleaning cloths, hospital cleaning staff are instructed to immerse the cloths in a bucket of disinfectant.
  • Third, the effectiveness of the staff's cleaning routines is tested using black-light markers.
According to the Center for Disease Control and Prevention (CDC), disinfectants approved by the U.S. Environmental Protection Agency (EPA) that specify effectiveness against Staphylococcus aureus can be used to control the spread of MRSA, provided that hospital staff follow instructions on the label including how long the cleaner should be in contact with the surface. The CDC notes that cleaning should be focused on those surfaces that come into contact with bare skin. Large surfaces such as walls and floors do not seem to play a role in HAP infections.

Implementing eco-friendly cleanining

Some medical facilities have chosen to implement green cleaning programs, which intend to protect public health by supporting infection control while also protecting patients, workers and the environment from toxic chemicals used in traditional cleaning products. Can hospitals with green cleaning programs still use disinfectants to control the spread of HAP, or is there a green alternative to these products?

hospital roomGreen cleaning expert Stephen Ashkin of The Ashkin Group, a consulting firm that specializes in helping contractors and building owners “green” the cleaning process, recommends choosing a standard EPA-approved disinfectant (PDF) in a more concentrated formula to reduce packaging. He also notes that some of these disinfectants have lower levels of volatile organic compounds (VOCs), making them less harmful to the environment and human health.

In fact, the eco-friendly healthcare organization Practice Greenhealth notes that because all disinfectants are intentionally toxic to microorganisms, none can be accurately called “green” – but that doesn't mean environmental cleaning for hospitals can't be both eco-friendly and effective against infectious bacteria. Practice Greenhealth asserts that green cleaning is not just about the products that are used, but the implementation of high-performance cleaning processes including standardized operations, staff training, protective equipment and clearly written policies and protocols for various levels of cleaning and response to the spills of bodily fluids.

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